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. 2023 Dec 27;12(1):65.
doi: 10.3390/biomedicines12010065.

Evaluating the Diagnostic Performance of Systemic Immune-Inflammation Index in Childhood Inflammatory Arthritis: A Focus on Differentiating Juvenile Idiopathic Arthritis from Reactive Arthritis

Delia-Maria Nicoară  1 , Andrei-Ioan Munteanu  1   2 , Alexandra-Cristina Scutca  1   2 , Giorgiana-Flavia Brad  1   2 , Raluca Asproniu  1   2 , Iulius Jugănaru  1   2   3 , Otilia Mărginean  1   2   3
Affiliations

Evaluating the Diagnostic Performance of Systemic Immune-Inflammation Index in Childhood Inflammatory Arthritis: A Focus on Differentiating Juvenile Idiopathic Arthritis from Reactive Arthritis

Delia-Maria Nicoară et al. Biomedicines. .

Abstract

In pediatric care, the range of potential diagnoses for arthritis can be relatively extensive, primarily involving infectious and inflammatory causes and, to a lesser extent, oncological conditions. Specifically, when addressing inflammatory causes, differentiating between Juvenile Idiopathic Arthritis (JIA) and Reactive Arthritis (ReA) can prove to be challenging during the first weeks, owing to the lack of specific antibodies in several JIA subtypes. This single-center retrospective study of 108 children with arthritis aimed to evaluate in greater detail the complete blood count (CBC) profiles of children with JIA and ReA in greater detail. The most significant differences were noted in terms of the Systemic Immune-Inflammation Index (SII), with higher values in the JIA group. Moreover, within the JIA group, SII displayed a significant positive correlation with conventional inflammatory biomarkers, specifically C-reactive protein (ρ = 0.579) and Erythrocyte Sedimentation Rate (ρ = 0.430). It was the only independent factor associated with the presence of JIA after adjusting for age (p = 0.030). Also, even with the moderate diagnostic value, the discriminating capacity of SII was superior to those of each of its component CBC parameters according to receiver operating characteristic (ROC) analysis. In summary, this study identified elevated SII values in the JIA group compared to the ReA group, indicating the potential utility of SII as an adjuvant discriminatory marker between these two arthritis forms.

Keywords: complete blood count; inflammation; juvenile idiopathic arthritis; reactive arthritis; systemic immune-inflammation index.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart illustrating the process for selecting patients.
Figure 2
Figure 2
Correlations between SII and (a) CRP, (b) ESR, and (c) fibrinogen across JIA group. Solid lines represent linear regression lines.
Figure 3
Figure 3
ROC curve of (a) CRP, (b) ESR, (c) SII, (d) NLR, (e) neutrophils, (f) lymphocytes, and (g) platelets for predicting partial clinical remission.
See this image and copyright information in PMC

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